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ANNUAL HEALTH SURVEY FACT SHEET First Updation round(2011-12) KEY FINDINGS

ANNUAL HEALTH SURVEY FACT SHEET First Updation round(2011-12) KEY FINDINGS. Dr. C. Chandramouli Registrar General & Census Commissioner, India.

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ANNUAL HEALTH SURVEY FACT SHEET First Updation round(2011-12) KEY FINDINGS

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  1. ANNUAL HEALTH SURVEYFACT SHEETFirst Updation round(2011-12)KEY FINDINGS Dr. C. ChandramouliRegistrar General & Census Commissioner, India

  2. “ Reproductive health and rights are integral to sustainable development and poverty reduction. Investing in universal access to reproductive health is crucial investment in healthy societies and a more sustainable future”. – Ban Ki-moon, Secretary-General, UN on World Population Day, 2012

  3. “ Working for the survival and the well being of women and girls is a human right imperative. And in order to take advantage of women’s full potential in the development of their nations, they must be able to plan their lives and families.” – Babatunde Osotimehin, Executive Director, UNFPA on World Population Day, 2012

  4. “ There should be an Annual Health Survey of all districts which could be published/monitored and compared against benchmarks” -Dr. Manmohan Singh, Prime Minister of India – In the meeting of National Commission of Population, 2005

  5. AHS provides key indicators on Reproductive and Child Health at District level in 8 EAG States and Assam Vital inputs for evidence based intervention and monitoring

  6. OBJECTIVE OF AHS • AHS yields a comprehensive, representative and reliable dataset on core vital indicators including composite ones like IMR, MMR and TFR along with their co-variates (process and outcome indicators) at the district level and maps changes therein on an annual basis. • These benchmarks help in better and holistic understanding and timely monitoring of various determinants on well-being and health of population particularly Reproductive and Child Health.

  7. Coverage : Annual Health Survey

  8. Indicators under AHS • In all, 161 indicators are available from AHS : • Fertility- 13  Sex Ratio- 3 • Marriage- 5  Mortality- 7 • Mother & Child Care- 63 • Ante Natal Care: 11  Delivery Care: 8 • Post Natal Care: 5  JananiSurakshaYojana (JSY): 3 • Immunization: 8  Vitamin A & Iron Supplements: 2 • Birth Weight: 2  Childhood Disease: 6 • Birth Registration: 2  Breastfeeding & Supplementation: 12 • Awareness in Mothers: 4 • Abortion- 6  Family Planning Practices- 15 • Disability- 1  Morbidity- 19 • Personal Habits:adults-4  Housing & HH Characteristics- 13 • Others- 12

  9. Indicators under AHS Contd… • Under 1st phase of release, following 9 indicators have already been released in the Bulletin 2011-12: • Crude Birth Rate (CBR)  Crude Death Rate (CDR) • Infant Mortality Rate (IMR)  Neo-Natal Mortality Rate (NNMR) • Under Five Mortality Rate (U5MR)  Maternal Mortality Ratio (MMR) • Sex Ratio at Birth (SRB)  Sex Ratio (0-4 years) and • Sex Ratio (All ages) • Remaining indicators are being released under present phase of dissemination.

  10. Five Core Themes Covered • The presentation focuses on results pertaining to 5 core themes: • Total Fertility Rate • Family Planning: Current Usage & Total Unmet Need • Ante Natal Care • Delivery & Post Natal Care • Immunization and Breast Feeding Practices

  11. KEY FINDINGS • Improvement has been noticed in most of the indicators as compared to Baseline. • Replacement level of TFR 2.1 has been achieved in only 29 out of 284 AHS districts whereas in Baseline it was 20 districts. • In 145 districts, on an average a woman bears more than 3 children. • More than half of currently married women aged 15-49 years are not using any method of family planning in Bihar.

  12. KEY FINDINGS • Female Sterilization continues to remain the most dominant method of family planning among the modern methods across all AHS States except Assam. • At least 12.6% currently married women are yet to meet their family planning requirement (Unmet Need) across all AHS States. This was 20.0% in Baseline. • Despite wider penetration of `Any ANC’, the coverage under ‘first trimester ANC’ as well as ‘3 or more ANCs’ needs further improvement.

  13. KEY FINDINGS • Poor performance of full ANC is primarily due to low IFA consumption. • Universal coverage of JSY remains a concern even in better performing States like Odisha, MP & Rajasthan. • Seven out of every 10 deliveries are ‘safe’ in Madhya Pradesh, Rajasthan, Odisha and Assam.

  14. At least 1 in 7 mothers has not received any PNC among all the AHS States, in Assam it is 1 in 3 mothers. • In full immunization, even the better performing States like Uttarakhand, Chhattisgarh and Rajasthan fall short by 22-30 percentage points in achieving universal coverage. • Percent of traditional method in any method of family planning is more than 20% in 4 States namely, Uttar Pradesh, Assam, Jharkhand & Odisha. KEY FINDINGS

  15. Performance of Hot Spot Districts • 55 districts are hotspots (57 in baseline) i.e. common in top 100 districts in IMR and top 25 Administrative Divisions (111 districts) in MMR. DISTRICTS FALLING IN BOTH TOP 100 IMR AND DISTRICTS OF TOP 25 MMR Assam- 6 UP - 31 Bihar -1 MP -16 Odisha -1

  16. State wiseTFR of Hot Spot Districts

  17. State wise Full ANC of Hot Spot Districts

  18. State wise Immunization in Hot Spot Districts

  19. State wise Institutional Delivery in Hot Spot Districts

  20. TOTAL FERTILITY RATE (TFR) • TFR is the average number of children born to a woman during her entire reproductive span. • Uttarakhand & Odisha and UP & Bihar continue to remain two extremes of the spectrum.

  21. TOTAL FERTILITY RATE (TFR) • Within a State, the minimum variability of 1.2 is reported in Uttarakhand and the maximum of 3.6 in Uttar Pradesh whereas in Baseline it was 1.3 in Chhattisgarh and 3.6 in Uttar Pradesh respectively . • Across 284 districts in 9 AHS States, it ranges from 1.7 in Pithoragarh and Bageshwar to 5.8 in Shrawasti. In Baseline this varied from 1.7 in Pithoragarh (Uttarakhand) to 5.9 in Shrawasti (UP)- a variability of more than 4 children.

  22. TOTAL FERTILITY RATE (TFR) 29 districts have already achieved the replacement level of 2.1 whereas it was 20 in baseline.

  23. TOTAL FERTILITY RATE (TFR)

  24. TOTAL FERTILITY RATE (TFR) • 229 districts have recorded less TFR than the baseline estimates and 47 districts remained same. • 8 Districts have recorded increase in TFR viz. Indore (M.P.), Baghpat, Budaun, Bulandshahar, Gonda, Lalitpur, Pilibhit and Rampur (U.P.) • 8 Districts have recorded maximum decrease in TFR viz. Sehore(M.P.), Basti, Deoria, Gorakhpur, Kaushambi, Kushinagar, Maharajganj, Siddharthnagar (U.P.)

  25. TOTAL FERTILITY RATE (TFR) Baseline First Updation Replacement level of TFR

  26. Family Planning: Current Usage • Contraceptive Prevalence Rate (CPR) is the percentage of currently married women aged 15-49 yrs who are using any method of contraception (modern/traditional). • Current usage of any method varies from 43.0 in Bihar to 66.4 in Rajasthan whereas it was 37.6 in Bihar to 64.5 per cent in Rajasthan in Baseline.

  27. Family Planning: Current Usage • Within a State, the least variation is reported in Uttarakhand and the most, in Odisha whereas in Baseline it was Uttarakhand and Uttar Pradesh respectively. • At district level, current usage of family planning ranges from 29.8 in Baudh (Odisha) to 89.1 in Hanumangarh (Rajasthan)- a variability of 3 times-whereas in Baseline it varied from 21.9 in Sitapur (UP) to 79.2 in Ganganagar (Rajasthan) exhibiting a variability of 4 times.

  28. Family Planning: Current Usage • As high as 71 districts are reporting less than 50% current usage of any method of family planning whereas in Baseline it was 98. • 39 districts feature in 70% & above category whereas in Baseline it was only 12 districts. • 29 out of 37 districts of Bihar have reported less than 50% usage of any method of family planning. In Baseline it was 35 districts.

  29. Family Planning: Current Usage First Updation Baseline CURRENT USAGE OF ANY METHOD OF FAMILY PLANNING (%) CURRENT USAGE OF ANY METHOD OF FAMILY PLANNING (%) Dist. with > 60% Usage

  30. Family Planning: Current Usage FEMALE STERILIZATION (%)

  31. Unmet Need for Family Planning • Unmet need of Family Planning broadly means requirement of Family Planning methods among Currently Married Women but not using any method of Family Planning . • Total unmet need varies from a minimum of 12.6% in Rajasthan to 33.5% in Bihar. In Baseline it varied from 19.6% in Rajasthan to 39.2% in Bihar. • Unmet need for Family Planning is a crucial indicator for assessing the future demand for Family Planning services / supplies.

  32. Unmet Need for Family Planning • The minimum variability within a State is in Uttarakhand and the maximum in Odisha whereas in Baseline it was in Uttarakhand and in Uttar Pradesh respectively. • Jhunjhunun (3.1) in Rajasthan and Dantewada (48.7) in Chhattisgarh are the two extremes across 284 districts. In Baseline it was Baleshwar (6.1) in Odisha and Sitapur (61.3) in Uttar Pradesh.

  33. Unmet Need for Family Planning • In 105 out of 284 districts, the total unmet need for family planning is below 20%. It was 69 in Baseline. • Bihar and Uttar Pradesh continue to dominate in 40% & above category.

  34. Unmet Need for Family Planning First Updation Baseline TOTAL UNMET NEED FOR FAMILY PLANNING (%) TOTAL UNMET NEED FOR FAMILY PLANNING (%) Unmet need of <=20

  35. Mean Age at Marriage- Female • Mean Age at Marriage is based on the marriages taken place during 2008-2010. • Mean age at marriage of females varies from 20.1 in Bihar to 22.4 years in Odisha whereas in Baseline it was 19.7 in Bihar & Rajasthan to 22.0 years in Uttarakhand.

  36. Marriages among Females below Legal Age (18 yrs) • Based on marriages taken place during 2008-2010. • Varies from 2.3% in Uttarakhand to 16.5% in Bihar whereas in Baseline it was 3.0% in Uttarakhand to 21.9% in Rajasthan.

  37. Marriages among Females below Legal Age (18 yrs) MARRIAGES AMONG FEMALES BELOW LEGAL AGE (BELOW 18 YEARS) %

  38. Ante Natal Care (ANC) • Any ANC exceeds 80% in all AHS States. • ANC in 1st trimester: 46.5% in UP & Bihar to 70% in Chhattisgarh & Madhya Pradesh. In Baseline, this was 40% in UP & Bihar to 65% in Chhattisgarh & Madhya Pradesh. • Mothers receiving 3 or more ANCs: UP-32.5% to Odisha-78.5%. This was UP-29.6% to Odisha-76.0 % in Baseline. • Mothers who consumed IFA 100 days or more: 8.1% in UP to 26.0% in Odisha. It was 6.5% in UP to 23.8% in Chhattisgarh in Baseline. • Low performance in IFA consumption is the main reason for sluggish full ANC: 5% in UP to 22.7% in Odisha. In Baseline, 3.9% in UP to 19.5% in Chhattisgarh.

  39. Full Ante Natal Check-up • Full ANC comprise 3 or more ANC, at least one TT injection and consumption of IFA for 100 or more days. • Uttar Pradesh reports the minimum coverage of 5.0 % and Odisha, the maximum 22.7 whereas in Baseline it was 3.9% in Uttar Pradesh & 19.5% in Chhattisgarh.

  40. Full Ante Natal Check-up • Bihar has reported the minimum variability among the districts in a State compared to Chhattisgarh reporting the maximum. It was Bihar and Odisha in Baseline. • Balrampur (0.9), less than 1% coverage and Jagatsinghapur (43.5), the maximum coverage of full ANC. In Baseline also the position was same with values 0.6 and 36.0 respectively.

  41. Full Ante Natal Check-up • 73 out of 284 districts report less than 5% coverage of full ANC whereas in Baseline it was 94. • 24 districts reported 25% & above coverage of full ANC . In Baseline it was only 15 districts.

  42. Full Ante Natal Check-up Baseline First Updation MOTHERS WHO HAD FULL ANTENATAL CHECK UP (%) MOTHERS WHO HAD FULL ANTENATAL CHECK UP (%)

  43. Ante Natal Check-up First Updation Baseline MOTHERS WHO RECEIVED ANY ANTENATAL CHECK-UP (%) MOTHERS WHO RECEIVED ANY ANTENATAL CHECK-UP (%) 90% and above coverage

  44. Ante Natal Check-up First Updation Baseline MOTHERS WHO HAD ANTENATAL CHECK UP IN FIRST TRIMESTER (%) MOTHERS WHO HAD ANTENATAL CHECK UP IN FIRST TRIMESTER (%) Above 50 % coverage

  45. Ante Natal Check-up Baseline First Updation MOTHERS WHO RECEIVED 3 OR MORE ANTENATAL CARE (%) MOTHERS WHO RECEIVED 3 OR MORE ANTENATAL CARE (%)

  46. Institutional Delivery

  47. Institutional Delivery • Institutional Delivery: Ranges from 40.4% in Chhattisgarh to 79.7% in MP. In Baseline it was 34.9% in Chhattisgarh & 76.1% in MP. • More than 85% of total births have taken place in Govt. Institutions in Madhya Pradesh & Odisha and it is more than 60% in remaining States except Jharkhand. In Baseline also, the situation was same except for Uttarakhand, which stood at 63% from 59% in Baseline. • Jharkhand continues to remain the only State where more than 50% of the births are taking place in Private Hospitals. • Balrampur (UP) recorded the least 22.2% institutional delivery whereas Puri(Odisha) the most 94.0%, showing a variability of more than 4 times. In Baseline, Balrampur was in the least category with 16.8% and Indore(MP),the highest with 92.5%.

  48. INSTITUTIONAL DELIVERY (%) Balrampur, UP Puri, Odisha • Institutional delivery is below 60% in 141 districts whereas it was 170 districts in baseline.

  49. Safe Delivery • Safe delivery comprise institutional deliveries and domiciliary deliveries assisted by doctor/nurse/ANM/LHV. • Safe Delivery: 51.8% in Jharkhand to 85.9% in Madhya Pradesh. It was 47.1% in Jharkhand & 82.2% in MP.

  50. Safe Delivery • Uttarakhand has exhibited the least variability among districts of a State and Uttar Pradesh, the most, the same as in Baseline. • Balrampur (UP) & Indore (MP) continue to remain the minimum and maximum in safe delivery.

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